The Compensation Fund aims to reduce claims backlog

16th May 2013

The Department of Labour’s Compensation Fund has completed 86 out of 142 cases of fraud and corruption within four months which resulted in the arrest and conviction of employees and medical health care providers, a meeting of the Portfolio Committee on Labour was told on Wednesday evening.

The Fund was briefing the committee on its preliminary annual performance, strategic plan for 2013 to 2018 as well as 2013/14 annual performance plan.

Shadrack Mkhonto, the Fund’s commissioner, said the drive against corruption and fraud has resulted among others, in two medical health care providers being convicted and sentenced to three years’ house arrest and five years suspension for both. The duo was ordered to pay back R2.1 million and R455,212 with 15 percent interest.

He said another four medical health care providers were currently on trial for defrauding the Fund to the value of R1,359,876.

Mkhonto said seven former employees of the Fund were also on trial for colluding with health care providers. Also, two health care providers were being disciplined by the Health Professions Council of South Africa.

He said as part of the fraud prevention strategy, the Fund was raising awareness to staff about the dangers this posed to service delivery.

Turning to strategies to reduce the claims backlog, the Fund said it aimed to finalise 100 percent of medical claims within 30 days of receiving an invoice by 2016.

“Equally, we want to be able to provide medical advice on all medical claims within 24 hours by 2016. We also intend developing a rehabilitation and reintegration policy framework and participate in consultative processes by 2014,’’ the commissioner said.

On the financial viability of the Fund, he said R1.6 billion was collected in quarter four against the annual target of R1 billion per annum of the debt book as at March 31, 2011.

“The implementation of the Return of Earnings website in 2012 for on-line submissions has been successful. For the period until March 31, this year, a total of 94 302 on-line submissions were received with the total revenue of R3,3 billion,’’ he said.

The committee heard that some of the key challenges facing the Fund included the delay or non-reporting of accidents, inadequate information technology systems as well as employer non-compliance with the law requiring them to report accidents.

Mkhonto said key strategic interventions to address the challenges included enhancement of the integrated claims and financial management systems to deal with the previous challenges – the implementation of the Revenue management strategy which includes the marketing of the Return of Earnings website to increase employers’ access and invoicing as well as creating incentives for filling on-line submission.

A further intervention is backlog management also known as the rescue plan dealing with claims registration and adjudication of claims.

Another intervention is the implementation of the approved organisational structure by advertising all critical posts. More interventions are the decentralisation of Compensation for Occupational Injuries Diseases Act (Coida) services to provinces – amendment of the Coida Act and engaging with the Fund’s stakeholders.

Also present at the briefing were Nkosinathi Nhleko, the labour department’s Director-General, Lerato Molebatsi, Deputy Director-General for Corporate Services as well as directors of Nedlac, Allistair Smith, Commission for Conciliation, Mediation and Arbitration, Nerine Kahn and Productivity SA, Bongani Coka.

First published by the SA Labour Guide